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<body>
<div class="dh">
    <div class="dhleft">
        <span>脑血管病及冠心病随访记录表</span>
    </div>
    <div class="bc" onclick="saveInfo()">
        <img  class="bcimg" src="../img/icon-save.png"/>
        <span class="bcspan">保存</span>
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<div class="maindiv">
    <div class="sfxx">
        <span class="sfxxspan">随访信息</span>
    </div>
    <div>
        <hr class="titleline" />
    </div>
    <div class="titlaspan">
        <span>基本信息</span>
    </div>
    <div class="titlebody">
        <div>
            <span class="span1">姓名：</span>
            <span  id="xm" style="margin-left:5px;"></span>
            <span class="span1" style="margin-left: 100px;" >性别：</span>
            <span  id="xb" style="margin-left:5px;"></span>
        </div>
        <div>
            <span class="span1">随访日期：</span>
            <input class="timeinput" id="happentime"  type="date"/>

        </div>
        <div>
            <span class="span1" >随访方式：</span>
            <input class="radio_type" type="radio" value="1" name="sffs" id="sffs1" checked="checked"/>
            <label for="sffs1">门诊</label>
            <input class="radio_type" type="radio" value="2" name="sffs" id="sffs2" />
            <label for="sffs2">家庭</label>
            <input class="radio_type" type="radio" value="3" name="sffs" id="sffs3" />
            <label for="sffs2">通过电话或者手机短信（微信）联系患者本人或者家人</label><br>
            <input class="radio_type" type="radio" style="margin-left: 105px;" value="4" name="sffs" id="sffs4" />
            <label for="sffs4">其他地方进行面对面教育</label>
            <input class="radio_type" type="radio" value="5" name="sffs" id="sffs5" />
            <label for="sffs5">其他</label>
        </div>
        <div>
            <span class="span1">是否本人：</span>
            <input class="radio_type" type="radio" onchange="sfbrcha(this.value)" name="sfbr" value="0" id="sfbr1" checked="checked"/>
            <label for="sfbr1">是</label>
            <input class="radio_type" type="radio" onchange="sfbrcha(this.value)" name="sfbr" value="1" id="sfbr2" />
            <label for="sfbr2">否</label>
            <span class="span1" style="width:auto;">提供信息者与被调查人直接的关系：</span>
            <input type="text" class="inputcss" id="tgrgx"/>
        </div>

    </div>
    <div class="titlaspan">
        <span>随访内容</span>
    </div>
    <div class="titlebody">
        <div>
            <span class="span1">身&nbsp;&nbsp;&nbsp;&nbsp;高：</span>
            <input type="number" id="height" style="width:50px;" class="inputcss"/><span class="dw">cm</span>
            <span class="span2">体重：</span>
            <input type="number" id="weight" style="width:50px;" class="inputcss"/><span class="dw">Kg</span>
            <span class="span2">腰围：</span>
            <input type="number" id="yaowei" style="width:50px;" class="inputcss"/><span class="dw">cm</span>
        </div>

        <div>
            <span class="span2">随访期间有无新发心脑血管疾病事件：</span>
            <input class="radio_type" type="radio" name="xfsj" onclick="fbcscli(this.value)" value="0" id="xfsj1" checked="checked"/>
            <label for="xfsj1">无</label>
            <input class="radio_type" type="radio" name="xfsj" onclick="fbcscli(this.value)" value="1" id="xfsj2" />
            <label for="xfsj2">有</label>
            <span class="span2">发病次数：</span>
            <input type="number" class="inputcss" id="fbcs"/>
        </div>
        <div>
            <span class="span1">诊断：</span>
            <input type="text" class="inputcss" id="zd" style="width: 100px;"/>
            <span class="span2">诊断机构：</span>
            <input type="text" class="inputcss" id="zdjg" style="width: 100px;"/>
        </div>
        <div>
            <span class="span1">血&nbsp;&nbsp;&nbsp;&nbsp;压：</span>
            <input type="number" class="inputcss" placeholder="高压" style="width: 50px;" id="gy"/><span class="dw">/</span><input type="number" style="width: 50px;"  placeholder="低压"  class="inputcss"  id="dy"/>
            <span class="span2">控制情况：</span>
            <input class="radio_type" type="radio" value="1" name="kzqk" id="kzqk1" checked="checked"/>
            <label for="kzqk1">达标</label>
            <input class="radio_type" type="radio" value="2" name="kzqk" id="kzqk2" />
            <label for="kzqk2">不达标</label>

        </div>
        <div>
            <span class="span2">随访期间是否新发现有高血压：</span>
            <input class="radio_type" type="radio" name="sfgxy" value="0" id="sfgxy1"/>
            <label for="sfgxy1">是</label>
            <input class="radio_type" type="radio" value="1" name="sfgxy" id="sfgxy2" />
            <label for="sfgxy2">否</label>
            <span class="span2">确诊时间：</span>
            <input class="timeinput" type="date" id="qztime"  />
        </div>
        <div>
            <span class="span1" style="width:auto">是否服用降压药：</span>
            <input class="radio_type" type="radio" value="0" name="sffy" id="sffy1"/>
            <label for="sffy1">是</label>
            <input class="radio_type" type="radio" value="1" name="sffy" id="sffy2" />
            <label for="sffy2">否</label>
            <span class="span2">用药情况：</span>
            <input class="radio_type" type="radio" value="1" name="yyqk" id="yyqk1"/>
            <label for="yyqk1">规律</label>
            <input class="radio_type" type="radio" value="2" name="yyqk" id="yyqk2" />
            <label for="yyqk2">不规律</label>
        </div>
        <div>
            <span class="span1">随访医生：</span>
            <select class="inputcss"   id="sfys">

            </select>
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        </div>

    </div>
</div>

</body>
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